Calidad de Vida y Cuidados Paliativos en Cáncer de Mama

Introducción: El cáncer de mama a menudo requiere tratamientos agresivos con efectos secundarios significativos. Los cuidados paliativos desempeñan un rol fundamental al aliviar síntomas, reducir el sufrimiento y mejorar la calidad de vida de las pacientes. Objetivo: Determinar la asociación entre la calidad de vida y cuidados paliativos en pacientes con cáncer de mama. Metodología: Estudio observacional, transversal comparativo, realizado en pacientes con cáncer de mama de la Unidad Médica de Atención Ambulatoria, Querétaro. Se incluyeron a pacientes con cáncer de mama confirmado por estudio histopatológico, se excluyeron a pacientes con enfermedades previas a cáncer de mama que afectara su calidad de vida, se eliminaron a pacientes con encuestas incompletas. El tamaño de la muestra se obtuvo con la fórmula para dos proporciones, con 31 participantes por grupo, obtenidos por casos consecutivos. Las variables estudiadas fueron edad, religión, escolaridad, estado civil, ocupación, estadio clínico de cáncer, con y sin cuidados paliativos y calidad de vida determinada por la escala QLQ-C30. Se aplicó estadística descriptiva con porcentajes y frecuencias, estadística inferencial con Chi2, OR con IC 95%. Resultados: El estudio incluyo a 62 participantes, el grupo con cuidados paliativos 41.9% (13) tenían buena calidad de vida en el estado global de salud, comparado con el 71% (22) del grupo control, Chi2 5.3, p valor=0.02, con buena calidad de vida en la dimensión de funcionalidad física 83.9% (26), en síntomas; náusea y vómito 16.1% (5), disnea 96.8% (30) Conclusiones: Existe asociación estadísticamente significativa en pacientes sin cuidados paliativos y calidad de vida.   Introduction: Breast cancer often requires aggressive treatments with significant side effects. Palliative care plays a key role in relieving symptoms, reducing suffering and improving patients' quality of life. Objective: To determine the association between quality of life and palliative care in breast cancer patients. Methodology: Observational, cross-sectional, comparative study, carried out in breast cancer patients at the Outpatient Medical Unit, Querétaro. Patients with breast cancer confirmed by histopathological study were included, patients with diseases prior to breast cancer that affected their quality of life were excluded, patients with incomplete surveys were eliminated. The sample size was obtained with the formula for two proportions, with 31 participants per group, obtained by consecutive cases. The variables studied were age, religion, schooling, marital status, occupation, clinical stage of cancer, with and without palliative care, and quality of life determined by the QLQ-C30 scale. Descriptive statistics were applied with percentages and frequencies, inferential statistics with Chi2, OR with 95% CI. Results: The study included 62 participants, the palliative care group 41.9% (13) had good quality of life in global health status, compared to 71% (22) of the control group, Chi2 5.3, p value=0.02, with good quality of life in the dimension of physical functionality 83.9% (26), in symptoms; nausea and vomiting 16.1% (5), dyspnea 96.8% (30) Conclusions: There is statistically significant association in patients without palliative care and quality of life

Darbepoetin Versus Epoetin Alfa for the Correction of Anemia in Cancer Patients Receiving Radiotherapy or Chemoradiotherapy Treatment

Introduction Anemia is the most frequent hematological disturbance in cancer patients, with prevalence between 30% and 90%, depending on the type of tumor, the antitumor treatment, and other factors (infection, malnutrition, bleeding, tumor infiltration of the bone marrow). A number of erythropoietic agents have shown to be effective in increasing the hemoglobin (Hb) levels, reducing the requirements for transfusion, and improving quality of life. The objective of this study is to compare darbepoetin alfa and epoetin alfa when used to correct anemia in cancer patients who are receiving radiotherapy or radiochemotherapy. Material and methods A prospective study of 125 consecutive patients with anemia (Hb < 13 g/dL in males or < 12 g/dL in females) who were undergoing treatment with radiotherapy (RT) or radiochemotherapy (RCT) in our department were enrolled between March 2003 and March 2005. The treatment for the anemia was either darbepoetin alfa 150 mcg/week (62 patients, group 1) or epoetin alfa 40,000 IU/week (63 patients, group 2). Patients received iron supplements in both groups. Treatment was administered in a consecutive manner depending on tumor type. If the increase in Hb was < 1 g/dL after 4 weeks of treatment, the dose was increased to 300 mcg/week in group 1 or to 60,000 IU/week in group 2. The treatment was terminated when a Hb value of ≥ 15 g/dL was reached during RT treatment, a Hb value of ≥ 14 g/dL was reached if the RT had been completed, or after 16 weeks of treatment whatever the Hb value. The mean age of patients was 63.36 ± 11.27 years, 67% were male. No significant differences were observed between the 2 groups in tumor type or stage, previous treatments, or intent to treat with RT or RCT. Results Comparing group 1 and group 2 by intent to treat, the mean Hb at the start of treatment with the study drug was 12.1 g/dL vs 11.8 g/dL, the proportion of patients whose dose was increased was19.7% vs 24.6%, the need for transfusion was 3.2% in each group, the duration of erythropoietic treatment was 6.5 weeks in both groups, and 2 patients in group 2 restarted treatment with epoetin alfa. The percentage of patients who responded (defined as an increase in the Hb ≥ 2 g/dL in the absence of transfusions) was of 72.6% and 66.7%, respectively. Four vascular adverse events were observed, 2 in each group. No significant differences were observed with respect to the baseline, week 4, and week 12 levels of endogenous erythropoietin, serum iron,% saturation, and ferritin. The increase in Hb 1 month after the final administration of the study drug was 2.21 g/dL in group 1 and 2.46 g/dL in group 2 (p = ns). Conclusions The results of our study demonstrate that both treatments are equally effective in correcting anemia in cancer patients undergoing RT or RCT

Electromagnetically-Induced-Transparency-Like Effect in the Degenerate Triple-Resonant Optical Parametric Amplifier

We investigate experimentally the absorptive and dispersive properties of triple-resonant optical parametric amplifier OPA for the degenerate subharmonic field. In the experiment, the subharmonic field is utilized as the probe field and the harmonic wave as the pump field. We demonstrate that EIT-like effect can be simulated in the triple-resonant OPA when the cavity line-width for the harmonic wave is narrower than that for the subharmonic field. However, this phenomenon can not be observed in a double-resonant OPA. The narrow transparency window appears in the reflected field. Especially, in the measured dispersive spectra of triple-resonant OPA, a very steep variation of the dispersive profile of the subharmonic field is observed, which can result in a slow light as that observed in atomic EIT medium.Comment: 10 pages, 4 figures, appear in Opt. Let

Routes for the electrochemical degradation of the artificial food azo-colour Ponceau 4R by advanced oxidation processes

The performance of three electrochemical advanced oxidation processes, namely electro-oxidation with electrogenerated H2O2 (EO-H2O2), electro-Fenton (EF) and photoelectro-Fenton (PEF) for the treatment of aqueous solutions of the food azo dye Ponceau 4R in an undivided cell with a BDD anode and an air-diffusion cathode was compared in terms of colour, dye concentration and total organic carbon (TOC) removals. PEF treatments in ultrapure water with Na2SO4 were performed to assess the effect of current density, as well as supporting electrolyte and dye concentrations. At 100 mA cm-2, solutions of 130 mL of 254 mg L-1 of the dye in 0.05 M Na2SO4 became colourless and totally mineralized after 50 and 240 min, respectively, which can be explained by the synergistic action of BDD(¿OH) at the anode surface and homogeneous ¿OH formed in the bulk from Fenton's reaction promoted in the presence of Fe2+ catalyst. Furthermore, UVA photons induced the continuous Fe2+ regeneration and photolytic decomposition of refractory intermediate complexes. In that aqueous matrix, the cleavage of the dye molecules proceeded through several reaction routes to yield N-containing and non-N-containing derivatives with one or two aromatic rings, short-chain aliphatic carboxylic acids and inorganic ions. Oxalic and oxamic acids and sulfate ions were accumulated at different rates in EO-H2O2, EF and PEF. The three methods allowed the progressive decontamination of Ponceau 4R solutions in a real water matrix even without the addition of electrolyte, although complete TOC abatement after 360 min at 33.3 mA cm-2 was only ensured by the iron-catalyzed PEF process

Insights into the metabolism and microbial biotransformation of dietary flavan-3-ols and the bioactivity of their metabolites.

Flavan-3-ols, occurring in monomeric, as well as in oligomeric and polymeric forms (also known as condensed tannins or proanthocyanidins), are among the most abundant and bioactive dietary polyphenols, but their in vivo health effects in humans may be limited because of their recognition as xenobiotics. Bioavailability of flavan-3-ols is largely influenced by their degree of polymerization; while monomers are readily absorbed in the small intestine, oligomers and polymers need to be biotransformed by the colonic microbiota before absorption. Therefore, phenolic metabolites, rather than the original high molecular weight compounds found in foods, may be responsible for the health effects derived from flavan-3-ol consumption. Flavan-3-ol phenolic metabolites differ in structure, amount and excretion site. Phase II or tissular metabolites derived from the small intestine and hepatic metabolism are presented as conjugated derivatives (glucuronic acid or sulfate esters, methyl ether, or their combined forms) of monomeric flavan-3-ols and are preferentially eliminated in the bile, whereas microbial metabolites are rather simple conjugated lactones and phenolic acids that are largely excreted in urine. Although the colon is seen as an important organ for the metabolism of flavan-3-ols, the microbial catabolic pathways of these compounds are still under consideration, partly due to the lack of identification of bacteria with such capacity. Studies performed with synthesized or isolated phase II conjugated metabolites have revealed that they could have an effect beyond their antioxidant properties, by interacting with signalling pathways implicated in important processes involved in the development of diseases, among other bioactivities. However, the biological properties of microbe-derived metabolites in their actual conjugated forms remain largely unknown. Currently, there is an increasing interest in their effects on intestinal infections, inflammatory intestinal diseases and overall gut health. The present review will give an insight into the metabolism and microbial biotransformation of flavan-3-ols, including tentative catabolic pathways and aspects related to the identification of bacteria with the ability to catabolize these kinds of polyphenols. Also, the in vitro bioactivities of phase II and microbial phenolic metabolites will be covered in detail

Optical and physicochemical characterizations of a cellulosic/CdSe-QDs@S-DAB5 film

CdSe quantum dots nanoparticles were coated with the thiolated (DiAminoButane based dendrimer) DAB dendrimer of fifth generation (S-DAB(5)) and embedded in a highly hydrophilic regenerated cellulose (RC) film by simple dip-coating method (immersion in QD-dendrimer aqueous solution) as a way to get a flexible nano-engineered film (RC-4/CdSe-QDs@S-DAB(5)) with high transparency and photoluminescence properties for different applications. Optical changes in the RC film associated with QDs inclusion were determined by spectroscopic ellipsometry (SE) measurements, which provide information on changes caused in the refraction index and the extinction coefficients of the film, as well as by light transmittance/reflectance curves and photoluminescence (PL) spectra. Impedance spectroscopy (IS) and other typical physicochemical techniques for material characterization (TEM, SEM and XPS) have also been used in order to have more complete information on film characteristics. A comparison of RC-4/CdSe-QDs@S-DAB(5) film optical characteristics with those exhibited by other RC-modified films depending on the type of dendrimer was also carried out